芪参通络解郁方联合度洛西汀治疗2型糖尿病伴抑郁的疗效观察

Effect of Qishen Tongluo Jieyu Decoction combined with duloxetine on type 2 diabetes mellitus with depression

目的分析芪参通络解郁方联合度洛西汀治疗2型糖尿病伴抑郁的疗效。方法选择2018年6月~2020年1月诊治的T2DM伴抑郁患者(气阴两虚型)87例。根据治疗方案不同将患者分为接受度洛西汀治疗对照组(n=42)和芪参通络解郁方联合度洛西汀治疗观察组(n=45)。比较两组患者血糖水平、抑郁状态、中医证候积分、临床疗效和不良反应情况。结果治疗后,两组患者糖化血红蛋白(HbA1c)、餐后血糖(PBG)和空腹血糖(FBG)水平较治疗前降低;且观察组患者治疗后HbA1c、PBG和FBG水平低于对照组(P<0.05)。治疗后,两组患者汉密尔顿抑郁量表(HAMD)评分较治疗前下降,且观察组患者治疗1周、4周、8周HAMD评分低于对照组(P<0.05)。治疗后,两组患者的精神疲乏、少气懒言、忧愁善感评分较治疗前降低;且观察组患者精神疲乏、少气懒言、忧愁善感评分低于对照组(P<0.05)。观察组患者临床总有效率高于对照组(P<0.05)。两组患者不良反应率比较差异无统计学意义(P>0.05)。结论芪参通络解郁方联合度洛西汀治疗2型糖尿病伴抑郁患者能明显提升临床疗效,改善抑郁症状。

Objective To analyze the efficacy of Qishen Tongluo Jieyu Decoction combined with duloxetine in the treatment of type 2 diabetes mellitus with depression.Methods 87 T2DM patients with depression(Qi and yin deficiency type)were selected from June 2018 to January 2020 in our hospital.According to different treatment schemes,patients were divided into duloxetine treatment control group(n=42)and Qishen Tongluo Jieyu Decoction combined with duloxetine treatment observation group(n=45).The blood glucose level,depression,TCM syndrome score,clinical efficacy and adverse reactions were compared between the two groups.Results After the treatment,the levels of glycosylated hemoglobin(HbA1c),postprandial blood glucose(PBG)and fasting blood glucose(FBG)in the two groups were lower than before treatment;and the levels of HbA1c,PBG and FBG in the observation group were lower than those in the control group after treatment(P<0.05).After treatment,the scores of Hamilton Depression Scale(HAMD)of the two groups were lower than before treatment,and the HAMD scores of the observation group were lower than those of the control group at 1 week,4 weeks and 8 weeks after treatment(P<0.05).After treatment,the scores of mental fatigue,lack of qi and no desire to speak,and melancholy in the two groups were lower than those before treatment;and the scores of mental fatigue,lack of qi and no desire to speak,and melancholy in the observation group were lower than those in the control group(P<0.05).The clinical effective rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the adverse reaction rate between the two groups(P>0.05).Conclusion Qishen Tongluo Jieyu Decoction combined with duloxetine in the treatment of type 2 diabetes mellitus with depression can significantly improve the clinical efficacy,improve the symptoms of depression,it is recommended to use.